BHP Rajal 30-05

TGL.PELAYANAN BATAL NO.
RM NAMA PASIEN CARA MASUK POLIKILINIK/ RUANG
01/09/2021 16:26:00 False 025900 YESI RAVIKA DURI RAWAT JALAN BEDAH
01/09/2021 16:26:00 False 025900 YESI RAVIKA DURI RAWAT JALAN BEDAH
30/08/2021 10:53:00 False 040334 HAWATI RAWAT JALAN BEDAH
02/09/2021 16:42:00 False 055635 BASA IRANI RAWAT JALAN BEDAH
01/09/2021 8:09:00 False 055658 ADI APRIAN RAWAT JALAN BEDAH
02/09/2021 10:17:00 False 066524 ANDI SUCIPTO RAWAT JALAN BEDAH
31/08/2021 7:52:00 False 076103 jamarali panggabean RAWAT JALAN BEDAH
31/08/2021 10:24:00 False 078655 MHD RAHMAN SAPUTRA RAWAT JALAN BEDAH
31/08/2021 10:24:00 False 078655 MHD RAHMAN SAPUTRA RAWAT JALAN BEDAH
02/09/2021 8:53:00 False 079826 RISNAWATI RAWAT JALAN BEDAH
04/09/2021 9:00:00 False 083645 NADIA FEMIA LOVELI RAWAT JALAN BEDAH
04/09/2021 7:29:00 False 088509 MUJIONO RAWAT JALAN BEDAH
31/08/2021 16:19:00 False 098254 SUTRISNO RAWAT JALAN BEDAH
02/09/2021 16:28:00 False 108694 MURNI BR SIJABAT RAWAT JALAN BEDAH
02/09/2021 9:11:00 False 109793 MARTINI PANJAITAN RAWAT JALAN BEDAH
01/09/2021 8:41:00 False 110205 ELVIDIANTO RAWAT JALAN BEDAH
04/09/2021 13:48:00 False 110412 ANTONIUS HALAWA RAWAT JALAN BEDAH
02/09/2021 8:27:00 False 110511 MARYATI RAWAT JALAN BEDAH
30/08/2021 16:41:00 False 110539 SANDIA LESTARI RAWAT JALAN BEDAH
30/08/2021 7:50:00 False 110678 DODI ARIANTO RAWAT JALAN BEDAH
02/09/2021 10:19:00 False 110696 SYAMSUAR RAWAT JALAN BEDAH
02/09/2021 10:19:00 False 110696 SYAMSUAR RAWAT JALAN BEDAH
01/09/2021 10:51:00 False 110743 WINDI PUSPITA SARI RAWAT JALAN BEDAH
01/09/2021 10:13:00 False 110818 ENDRI EFFENDI RAWAT JALAN BEDAH
04/09/2021 8:29:00 False 110912 AYU ULFIANI HIDAYAH RAWAT JALAN BEDAH
04/09/2021 8:29:00 False 110912 AYU ULFIANI HIDAYAH RAWAT JALAN BEDAH
30/08/2021 8:53:00 False 110940 AMELIA CAHAYA PUTRI RAWAT JALAN BEDAH
30/08/2021 8:17:00 False 110994 NARA DEA RAWAT JALAN BEDAH
30/08/2021 8:17:00 False 110994 NARA DEA RAWAT JALAN BEDAH
31/08/2021 14:25:00 False 111029 MUHAMMAD RISKY SYAHPUTRA RAWAT JALAN BEDAH
31/08/2021 14:25:00 False 111029 MUHAMMAD RISKY SYAHPUTRA RAWAT JALAN BEDAH
04/09/2021 11:53:00 False 111065 RINI SAHARANI RAWAT JALAN BEDAH
30/08/2021 16:49:00 False 111111 DAFFA AL FARISY EVRANDA RAWAT JALAN BEDAH
30/08/2021 16:49:00 False 111111 DAFFA AL FARISY EVRANDA RAWAT JALAN BEDAH
36
CARA BAYAR DOKTER (DPJP) DOKTER/ OPERATOR/ PELAKSANA FREQ
BPJS NON-PBI RURI GUSANDI, DR, SPB ELAYANI, AMD. KEP 1
BPJS NON-PBI RURI GUSANDI, DR, SPB RURI GUSANDI, DR, SPB 1
BPJS NON-PBI RURI GUSANDI, DR, SPB RADIOGRAFER 1
BPJS KETENAGAKERJAAN RURI GUSANDI, DR, SPB RURI GUSANDI, DR, SPB 1
BPJS KETENAGAKERJAAN RURI GUSANDI, DR, SPB RURI GUSANDI, DR, SPB 1
BPJS NON-PBI GUMANA UHUM P SITOMPUL, SP.B GUMANA UHUM P SITOMPUL, SP.B 1
UMUM RURI GUSANDI, DR, SPB RURI GUSANDI, DR, SPB 1
UMUM RURI GUSANDI, DR, SPB RURI GUSANDI, DR, SPB 1
JENIS PELAYANAN BAHP TGL.PULANG
PASANG INFUS 10,000 03/09/2021 15:56:00
EKG 15,000 03/09/2021 15:56:00
GANTI VERBAN SEDANG 30,000 30/08/2021 10:53:00
GANTI VERBAN SEDANG (6-20 PCS KASSA) 30,000 01/09/2021 8:09:00
USG KELUAR 360,000 02/09/2021 10:17:00
AFF HEACTING 16,000 31/08/2021 10:24:00
KONTROL ULANG AFF JAHITAN/JAHITAN 5,000 02/09/2021 10:19:00
GANTI VERBAN BESAR 35,000 01/09/2021 10:13:00
AFF HEACTING 32,000 04/09/2021 8:29:00
AFF HEACTING 16,000 03/09/2021 8:12:00
AFF HEACTING 16,000 30/08/2021 8:17:00
GANTI VERBAN KECIL (1-5 PCS KASSA) 20,000 31/08/2021 14:25:00
AFF HEACTING 16,000 31/08/2021 14:25:00
AFF HEACTING 16,000 30/08/2021 16:49:00
1,427,000
TGL.PELAYANAN BATAL NO.RM NAMA PASIEN CARA MASUK POLIKILINIK/ RUANG
02/09/2021 15:18:30 False 038801 FITRA RAHMAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 15:37:00 False 040734 SYUKRI RAWAT DARURAT PELAYANAN RAWAT DARURAT
03/09/2021 8:59:08 False 041789 YUSNIMAR RAWAT DARURAT PELAYANAN RAWAT DARURAT
05/09/2021 10:10:54 False 047642 MUHAMMAD ZULFIKAR DAMANIK RAWAT DARURAT PELAYANAN RAWAT DARURAT
02/09/2021 15:16:21 False 049975 NURAIDA RAWAT DARURAT PELAYANAN RAWAT DARURAT
30/08/2021 0:20:00 False 051944 JEVIONER RAWAT DARURAT PELAYANAN RAWAT DARURAT
03/09/2021 14:48:00 False 053204 JANEWAR RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 20:23:25 False 055311 MEGAWATI RAWAT DARURAT PELAYANAN RAWAT DARURAT
31/08/2021 21:16:23 False 055382 JUNIARTA SIAHAAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
31/08/2021 21:16:39 False 055382 JUNIARTA SIAHAAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
30/08/2021 2:05:15 False 066149 SYUKUR HURA RAWAT DARURAT PELAYANAN RAWAT DARURAT
30/08/2021 0:22:30 False 074166 RIZKI ARLINA RAWAT DARURAT PELAYANAN RAWAT DARURAT
02/09/2021 9:44:30 False 075437 SAMSUDIN RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 4:11:10 False 082776 SAKHIEL RAMADHAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 4:11:50 False 082776 SAKHIEL RAMADHAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
30/08/2021 12:29:30 False 088133 GHUFRON HAKIM RAWAT DARURAT PELAYANAN RAWAT DARURAT
03/09/2021 21:03:05 False 088540 AZ ZAHRA RAHAYU SEPTIANINGSIH RAWAT DARURAT PELAYANAN RAWAT DARURAT
30/08/2021 21:25:55 False 088841 ERNI KARMILA NASUTION RAWAT DARURAT PELAYANAN RAWAT DARURAT
31/08/2021 23:48:09 False 089388 YONNITA RAWAT DARURAT PELAYANAN RAWAT DARURAT
05/09/2021 7:31:11 False 090061 raziq zhafran andeza RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 1:29:28 False 091460 KEYSIA MEIDITA JOLA SIREGAR RAWAT DARURAT PELAYANAN RAWAT DARURAT
30/08/2021 19:19:26 False 093142 SITI AISAH RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 8:48:27 False 102882 ARTSON MARCELLO RAWAT DARURAT PELAYANAN RAWAT DARURAT
03/09/2021 20:32:53 False 104374 HIBRATUL AL KARRIM CHANDRA RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 16:42:47 False 106605 AMRIZAL RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 16:43:09 False 106605 AMRIZAL RAWAT DARURAT PELAYANAN RAWAT DARURAT
31/08/2021 3:41:46 False 107975 AMZAR CHAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 16:22:03 False 110129 KIKI RISKI ANANDA RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 22:14:08 False 110176 LUCIA SISKA RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 22:14:51 False 110176 LUCIA SISKA RAWAT DARURAT PELAYANAN RAWAT DARURAT
30/08/2021 8:51:00 False 110201 ROSLINDA RAWAT DARURAT PELAYANAN RAWAT DARURAT
31/08/2021 17:15:31 False 110812 ENDRICO RAWAT DARURAT PELAYANAN RAWAT DARURAT
05/09/2021 9:18:44 False 111259 ROSINTA RAWAT DARURAT PELAYANAN RAWAT DARURAT
05/09/2021 9:20:13 False 111259 ROSINTA RAWAT DARURAT PELAYANAN RAWAT DARURAT
31/08/2021 3:43:54 False 111266 SUANDI RAWAT DARURAT PELAYANAN RAWAT DARURAT
31/08/2021 0:41:00 False 111267 ZULKIFLI RAWAT DARURAT PELAYANAN RAWAT DARURAT
31/08/2021 10:24:49 False 111282 RUSMANAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
31/08/2021 21:17:22 False 111297 KIPLI AKBAR NASUTION RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 12:44:17 False 111319 UMRI KHOLID RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 12:43:05 False 111322 SIXTUS SIHOMBING RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 13:13:25 False 111323 LUSIANA PERMATA HATI RAWAT DARURAT PELAYANAN RAWAT DARURAT
MANURUNG
MANURUNG
MANURUNG
MANURUNG
MANURUNG
MANURUNG
MANURUNG
01/09/2021 18:37:19 False 111331 FELIX FERGUSON PURBA RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 20:18:01 False 111333 MARLIANA RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 20:28:55 False 111333 MARLIANA RAWAT DARURAT PELAYANAN RAWAT DARURAT
01/09/2021 22:34:26 False 111338 DEWI RARA ANJENI RAWAT DARURAT PELAYANAN RAWAT DARURAT
02/09/2021 16:43:41 False 111367 DILLA ALFIENI RAWAT DARURAT PELAYANAN RAWAT DARURAT
03/09/2021 0:24:11 False 111375 TAMBA SILIAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
03/09/2021 20:33:46 False 111439 SUWARNO RAWAT DARURAT PELAYANAN RAWAT DARURAT
03/09/2021 20:34:04 False 111439 SUWARNO RAWAT DARURAT PELAYANAN RAWAT DARURAT
03/09/2021 21:27:21 False 111442 YULINAR RAWAT DARURAT PELAYANAN RAWAT DARURAT
03/09/2021 21:27:51 False 111442 YULINAR RAWAT DARURAT PELAYANAN RAWAT DARURAT
03/09/2021 23:02:46 False 111443 AZKA SEBASTIAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 8:45:06 False 111450 ELSYE FEBLICA MARBUN RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 8:45:37 False 111450 ELSYE FEBLICA MARBUN RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 10:54:23 False 111456 PARIANI RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 11:08:00 False 111471 BILQIS PUTRI MAHARANI RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 19:41:45 False 111528 PUTRI RAMA SIHOMBING RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 19:41:21 False 111531 RAFATHAR FERDINAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
04/09/2021 21:32:38 False 111542 JOICE MARIA SILALAHI RAWAT DARURAT PELAYANAN RAWAT DARURAT
05/09/2021 8:08:59 False 111545 RONI TIWARMAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
05/09/2021 8:02:00 False 111545 RONI TIWARMAN RAWAT DARURAT PELAYANAN RAWAT DARURAT
05/09/2021 10:43:23 False 111546 DEWI FEBRIYENI RAWAT DARURAT PELAYANAN RAWAT DARURAT
05/09/2021 16:00:00 False 111548 YELSA DAMAYANTI RAWAT DARURAT PELAYANAN RAWAT DARURAT
05/09/2021 16:00:00 False 111548 YELSA DAMAYANTI RAWAT DARURAT PELAYANAN RAWAT DARURAT
05/09/2021 16:01:00 False 111549 ESTER CAROLIN RAWAT DARURAT PELAYANAN RAWAT DARURAT
134
CARA BAYAR DOKTER (DPJP) DOKTER/ OPERATOR/ PELAKSANA FREQ JENIS PELAYANAN BAHP
BPJS NON-PBI BIMA NAZIR, DR NURHELINDA RIZDA, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI RURI GUSANDI, DR, SPB PERAWAT/ BIDAN 1 PASANG INFUS 10,000
BPJS NON-PBI BELLA TAMARA,DR NURHELINDA RIZDA, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI BELLA TAMARA,DR NURHELINDA RIZDA, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI BELLA TAMARA,DR NURHELINDA RIZDA, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI BELLA TAMARA,DR WIDYA ASTUTI, AMD. KEB 1 OKSIGEN (LITER PER JAM) 36,000
BPJS NON-PBI BELLA TAMARA,DR WIDYA ASTUTI, AMD. KEB 1 EKG 15,000
BPJS NON-PBI BELLA TAMARA,DR RADIOGRAFER 1 THORAX AP/PA 45,000
BPJS NON-PBI BELLA TAMARA,DR NURHELINDA RIZDA, AMD. KEB 1 AFF INFUS 10,000
BPJS NON-PBI BELLA TAMARA,DR KATRISIA POPILINA, S. KEP. NS 1 WT KECIL 20,000
BPJS NON-PBI AIDI NASRUL, DR, SP.PD NURHELINDA RIZDA, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI AIDI NASRUL, DR, SP.PD NURHELINDA RIZDA, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI AIDI NASRUL, DR, SP.PD MUHAMMAD YUSUF, DR 1 THORAX AP/PA 45,000
BPJS NON-PBI AIDI NASRUL, DR, SP.PD WIDYA ASTUTI, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI AIDI NASRUL, DR, SP.PD WIDYA ASTUTI, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI AIDI NASRUL, DR, SP.PD WIDYA ASTUTI, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI WIWING MARISYA, DR PERAWAT/ BIDAN 1 INJEKSI 2,000
BPJS NON-PBI BIMA NAZIR, DR WARMAN, S.KEP, NS 1 INJEKSI 2,000
BPJS NON-PBI DEA OKTOVIANI,DR NURHELINDA RIZDA, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI DEA OKTOVIANI,DR NURHELINDA RIZDA, AMD. KEB 1 EKG 15,000
BPJS NON-PBI ROMAITO NASUTION, DR, SP.P DISTI ALMAHARA TAMA, AMD. 1 OKSIGEN (LITER PER JAM) 36,000
KEP
BPJS NON-PBI ROMAITO NASUTION, DR, SP.P WIDYA ASTUTI, AMD. KEB 1 NEBULIZER 5,000
BPJS NON-PBI ROMAITO NASUTION, DR, SP.P DISTI ALMAHARA TAMA, AMD. 1 PASANG INFUS 10,000
KEP
BPJS NON-PBI ROMAITO NASUTION, DR, SP.P DISTI ALMAHARA TAMA, AMD. 1 INJEKSI 2,000
KEP
KEP
KEP
KEP
BPJS NON-PBI ROMAITO NASUTION, DR, SP.P DISTI ALMAHARA TAMA, AMD. 1 NEBULIZER 5,000
KEP
BPJS NON-PBI WIWING MARISYA, DR DISTI ALMAHARA TAMA, AMD. 1 WT KECIL 20,000
KEP
BPJS NON-PBI BIMA NAZIR, DR EKA ISMALYAH HRP, AMD. KEP 1 OKSIGEN (LITER PER JAM) 36,000
BPJS NON-PBI WIWING MARISYA, DR NURIAWATI S.PUTRI 1 NEBULIZER 10,000

DEWI,AMD.KEB
BPJS NON-PBI WIWING MARISYA, DR NURIAWATI S.PUTRI 1 OKSIGEN (LITER PER JAM) 36,000
DEWI,AMD.KEB
BPJS NON-PBI DEA OKTOVIANI,DR WARMAN, S.KEP, NS 1 INJEKSI 2,000
BPJS NON-PBI RIRI PRATIWI S, DR NURIAWATI S.PUTRI 1 INJEKSI 2,000

DEWI,AMD.KEB
BPJS NON-PBI AIDI NASRUL, DR, SP.PD NURIAWATI S.PUTRI 1 EKG 15,000
DEWI,AMD.KEB
BPJS NON-PBI AIDI NASRUL, DR, SP.PD DISTI ALMAHARA TAMA, AMD. 1 PASANG INFUS 10,000
KEP
BPJS NON-PBI AIDI NASRUL, DR, SP.PD DISTI ALMAHARA TAMA, AMD. 1 INJEKSI 2,000
KEP
BPJS NON-PBI AIDI NASRUL, DR, SP.PD NURIAWATI S.PUTRI 1 PASANG INFUS 10,000
DEWI,AMD.KEB
BPJS NON-PBI AIDI NASRUL, DR, SP.PD NURIAWATI S.PUTRI 1 OKSIGEN (LITER PER JAM) 36,000
DEWI,AMD.KEB
BPJS NON-PBI AIDI NASRUL, DR, SP.PD NURIAWATI S.PUTRI 1 INJEKSI 2,000
DEWI,AMD.KEB
BPJS NON-PBI WIWING MARISYA, DR DISTI ALMAHARA TAMA, AMD. 1 INJEKSI 2,000
KEP
BPJS NON-PBI WIWING MARISYA, DR DISTI ALMAHARA TAMA, AMD. 1 OKSIGEN (LITER PER JAM) 36,000
KEP
BPJS NON-PBI RIRI PRATIWI S, DR EKA ISMALYAH HRP, AMD. KEP 1 NEBULIZER 5,000
BPJS NON-PBI RIRI PRATIWI S, DR EKA ISMALYAH HRP, AMD. KEP 1 OKSIGEN (LITER PER JAM) 36,000
BPJS NON-PBI RIRI PRATIWI S, DR KATRISIA POPILINA, S. KEP. NS 1 NEBULIZER 5,000
BPJS NON-PBI NOVRA TILOVA, DR EKA ISMALYAH HRP, AMD. KEP 1 NEBULIZER 5,000
BPJS NON-PBI RAFISHA PUTRI FELLADIRA, DR IWAN, AMD. KEP 1 NEBULIZER 5,000
BPJS NON-PBI RAFISHA PUTRI FELLADIRA, DR WARMAN, S.KEP, NS 1 WT KECIL 20,000
UMUM RIRI PRATIWI S, DR DISTI ALMAHARA TAMA, AMD. 1 OKSIGEN (LITER PER JAM) 50,000
KEP
BPJS NON-PBI BIMA NAZIR, DR BIMA NAZIR, DR 1 RJP/ RESUSITASI JANTUNG 21,000
PARU
BPJS NON-PBI BIMA NAZIR, DR NURIAWATI S.PUTRI 1 EKG 15,000
DEWI,AMD.KEB
BPJS NON-PBI AIDI NASRUL, DR, SP.PD DISTI ALMAHARA TAMA, AMD. 1 PASANG INFUS 10,000
KEP
BPJS NON-PBI AIDI NASRUL, DR, SP.PD DISTI ALMAHARA TAMA, AMD. 1 INJEKSI 2,000
KEP
BPJS NON-PBI AIDI NASRUL, DR, SP.PD DISTI ALMAHARA TAMA, AMD. 1 EKG 15,000
KEP
BPJS NON-PBI AIDI NASRUL, DR, SP.PD EKA ISMALYAH HRP, AMD. KEP 1 PASANG INFUS 10,000
BPJS NON-PBI AIDI NASRUL, DR, SP.PD IWAN, AMD. KEP 1 INJEKSI 2,000
BPJS NON-PBI AIDI NASRUL, DR, SP.PD RIRI PRATIWI S, DR 1 EKG 15,000
UMUM MADUMA OCTHA MARINI S, DINA MARYANA, AMD. KEB 1 PASANG INFUS 10,000
DR.SPOG
UMUM MADUMA OCTHA MARINI S, DINA MARYANA, AMD. KEB 1 PASANG CATETER 38,000
DR.SPOG
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG WARMAN, S.KEP, NS 1 PASANG INFUS 10,000
BPJS NON-PBI DEA OKTOVIANI,DR IWAN, AMD. KEP 1 PASANG CATETER 38,000
BPJS NON-PBI BELLA TAMARA,DR KATRISIA POPILINA, S. KEP. NS 1 INJEKSI 2,000
BPJS NON-PBI BELLA TAMARA,DR KATRISIA POPILINA, S. KEP. NS 1 INJEKSI 2,000
BPJS NON-PBI RIRI PRATIWI S, DR NURIAWATI S.PUTRI 1 OKSIGEN (LITER PER JAM) 8,000
DEWI,AMD.KEB
BPJS NON-PBI RIRI PRATIWI S, DR NURIAWATI S.PUTRI 1 EKG 15,000
DEWI,AMD.KEB
BPJS NON-PBI RIRI PRATIWI S, DR NURIAWATI S.PUTRI 1 RJP/ RESUSITASI JANTUNG 21,000
DEWI,AMD.KEB PARU
UMUM RIRI PRATIWI S, DR PERAWAT/ BIDAN 1 INJEKSI 2,000
UMUM RIRI PRATIWI S, DR RADIOGRAFER 1 CRANIUM AP + LATERAL 90,000
UMUM RIRI PRATIWI S, DR DISTI ALMAHARA TAMA, AMD. 1 WT KECIL 20,000

KEP
UMUM RIRI PRATIWI S, DR DISTI ALMAHARA TAMA, AMD. 1 HECTING 1 - 5 55,000
KEP
UMUM RAFISHA PUTRI FELLADIRA, DR RADIOGRAFER 1 ABDOMEN AP 45,000
UMUM RURI GUSANDI, DR, SPB IWAN, AMD. KEP 1 WT BESAR 35,000
UMUM RURI GUSANDI, DR, SPB KATRISIA POPILINA, S. KEP. NS 1 PASANG INFUS 10,000
UMUM RURI GUSANDI, DR, SPB KATRISIA POPILINA, S. KEP. NS 1 INJEKSI 2,000
UMUM RURI GUSANDI, DR, SPB KATRISIA POPILINA, S. KEP. NS 1 INJEKSI KHUSUS 75,000
BPJS NON-PBI INTAN YULIASARI, DR, MSC,SP.S MUHAMMAD YUSUF, DR 1 THORAX AP/PA 45,000
BPJS NON-PBI INTAN YULIASARI, DR, MSC,SP.S IWAN, AMD. KEP 1 PASANG INFUS 10,000
BPJS NON-PBI INTAN YULIASARI, DR, MSC,SP.S IWAN, AMD. KEP 1 INJEKSI 2,000
BPJS NON-PBI INTAN YULIASARI, DR, MSC,SP.S IWAN, AMD. KEP 1 INJEKSI 2,000
BPJS NON-PBI INTAN YULIASARI, DR, MSC,SP.S IWAN, AMD. KEP 1 EKG 15,000
UMUM RIRI PRATIWI S, DR MUHAMMAD YUSUF, DR 1 CRURIS AP +LATERAL 45,000
BPJS NON-PBI RURI GUSANDI, DR, SPB WARMAN, S.KEP, NS 1 PASANG INFUS 10,000
BPJS NON-PBI RURI GUSANDI, DR, SPB WARMAN, S.KEP, NS 1 INJEKSI 2,000
BPJS NON-PBI RURI GUSANDI, DR, SPB WARMAN, S.KEP, NS 1 PASANG CATETER 38,000
BPJS NON-PBI RURI GUSANDI, DR, SPB WIDYA ASTUTI, AMD. KEB 1 INJEKSI 2,000
UMUM BIMA NAZIR, DR WARMAN, S.KEP, NS 1 WT SEDANG 30,000
UMUM BIMA NAZIR, DR WARMAN, S.KEP, NS 1 HECTING 1 - 5 117,370
UMUM BIMA NAZIR, DR BIMA NAZIR, DR 1 INJEKSI 2,000
UMUM BIMA NAZIR, DR WARMAN, S.KEP, NS 1 OKSIGEN (LITER PER JAM) 50,000
UMUM BIMA NAZIR, DR WARMAN, S.KEP, NS 1 INJEKSI 2,000
BPJS NON-PBI RURI GUSANDI, DR, SPB KATRISIA POPILINA, S. KEP. NS 1 PASANG INFUS 10,000
BPJS NON-PBI RURI GUSANDI, DR, SPB KATRISIA POPILINA, S. KEP. NS 1 INJEKSI 2,000
BPJS NON-PBI NOVRA TILOVA, DR NURHELINDA RIZDA, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI BELLA TAMARA,DR WIDYA ASTUTI, AMD. KEB 1 INJEKSI 2,000
UMUM RIRI PRATIWI S, DR RIRI PRATIWI S, DR 1 EKG 15,000
UMUM RIRI PRATIWI S, DR NURIAWATI S.PUTRI 1 OKSIGEN (LITER PER JAM) 50,000
DEWI,AMD.KEB
BPJS NON-PBI RIRI PRATIWI S, DR DISTI ALMAHARA TAMA, AMD. 1 OKSIGEN (LITER PER JAM) 36,000
KEP
BPJS NON-PBI RIRI PRATIWI S, DR DISTI ALMAHARA TAMA, AMD. 1 NEBULIZER 5,000
KEP
UMUM NOVRA TILOVA, DR IWAN, AMD. KEP 1 INJEKSI 2,000
UMUM NOVRA TILOVA, DR NOVRA TILOVA, DR 1 WT KECIL 20,000
UMUM NOVRA TILOVA, DR NOVRA TILOVA, DR 1 HECTING 1 - 5 67,000
UMUM NOVRA TILOVA, DR DISTI ALMAHARA TAMA, AMD. 1 EKG 15,000

KEP
UMUM NOVRA TILOVA, DR WARMAN, S.KEP, NS 1 INJEKSI 2,000
BPJS NON-PBI AIDI NASRUL, DR, SP.PD WARMAN, S.KEP, NS 1 PASANG INFUS 10,000
BPJS NON-PBI AIDI NASRUL, DR, SP.PD WARMAN, S.KEP, NS 1 INJEKSI 2,000
UMUM RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 WT KECIL 20,000
UMUM H.R.ROSENO SARJANTO,DR, SPOG KATRISIA POPILINA, S. KEP. NS 1 PASANG INFUS 10,000
UMUM H.R.ROSENO SARJANTO,DR, SPOG NURIAWATI S.PUTRI 1 INJEKSI 2,000

DEWI,AMD.KEB
DEWI,AMD.KEB
DEWI,AMD.KEB
BPJS NON-PBI BIMA NAZIR, DR KATRISIA POPILINA, S. KEP. NS 1 WT KECIL 20,000
BPJS NON-PBI FANEL PUTRA, DR.SP.N KATRISIA POPILINA, S. KEP. NS 1 OKSIGEN (LITER PER JAM) 8,000
BPJS NON-PBI FANEL PUTRA, DR.SP.N NURHELINDA RIZDA, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI FANEL PUTRA, DR.SP.N NURHELINDA RIZDA, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI FANEL PUTRA, DR.SP.N EKA ISMALYAH HRP, AMD. KEP 1 EKG 15,000
UMUM BELLA TAMARA,DR MUHAMMAD YUSUF, DR 1 PELVIC 45,000
UMUM BELLA TAMARA,DR BELLA TAMARA,DR 1 WT KECIL 20,000
BPJS NON-PBI BELLA TAMARA,DR KATRISIA POPILINA, S. KEP. NS 1 OKSIGEN (LITER PER JAM) 36,000
UMUM WIWING MARISYA, DR PERAWAT/ BIDAN 1 OKSIGEN (LITER PER JAM) 50,000
UMUM WIWING MARISYA, DR PERAWAT/ BIDAN 1 WT KECIL 20,000
UMUM WIWING MARISYA, DR PERAWAT/ BIDAN 1 WT KECIL 20,000
2,227,370
TGL.PULANG
02/09/2021 14:37:00
05/09/2021 11:41:00
03/09/2021 6:39:00
03/09/2021 6:39:00
03/09/2021 6:39:00
03/09/2021 6:39:00
03/09/2021 6:39:00
03/09/2021 6:39:00
03/09/2021 6:39:00
05/09/2021 8:57:00
03/09/2021 9:09:00
03/09/2021 9:09:00
03/09/2021 9:09:00
03/09/2021 9:09:00
03/09/2021 9:09:00
05/09/2021 16:14:00
05/09/2021 16:14:00
05/09/2021 16:14:00
03/09/2021 14:48:00
01/09/2021 19:21:00
31/08/2021 21:12:00
31/08/2021 21:12:00
02/09/2021 18:08:00
02/09/2021 18:08:00
02/09/2021 18:08:00
02/09/2021 18:08:00
02/09/2021 18:08:00
02/09/2021 18:08:00
02/09/2021 18:08:00
02/09/2021 18:08:00
29/08/2021 23:44:00
02/09/2021 9:09:00
01/09/2021 3:43:00
01/09/2021 3:43:00
30/08/2021 12:10:00
03/09/2021 20:56:00
03/09/2021 21:02:00
03/09/2021 21:02:00
03/09/2021 21:02:00
03/09/2021 21:02:00
04/09/2021 15:02:00
04/09/2021 15:02:00
04/09/2021 15:02:00
05/09/2021 20:34:00
05/09/2021 20:34:00
05/09/2021 7:27:00
05/09/2021 7:27:00
05/09/2021 7:27:00
04/09/2021 1:23:00
30/08/2021 19:03:00
04/09/2021 8:43:00
03/09/2021 17:54:00
04/09/2021 16:26:00
04/09/2021 16:26:00
03/09/2021 16:06:00
03/09/2021 16:06:00
03/09/2021 16:06:00
03/09/2021 9:06:00
03/09/2021 9:06:00
03/09/2021 9:06:00
03/09/2021 11:54:00
03/09/2021 11:54:00
02/09/2021 16:07:00
31/08/2021 16:07:00
05/09/2021 9:00:00
05/09/2021 9:00:00
30/08/2021 22:14:00
30/08/2021 22:14:00
30/08/2021 22:14:00
31/08/2021 0:41:00
31/08/2021 0:41:00
31/08/2021 0:41:00
31/08/2021 0:41:00
31/08/2021 9:27:00
05/09/2021 10:59:00
05/09/2021 10:59:00
05/09/2021 10:59:00
05/09/2021 10:59:00
05/09/2021 10:59:00
05/09/2021 10:59:00
02/09/2021 17:20:00
02/09/2021 17:20:00
02/09/2021 17:20:00
02/09/2021 17:20:00
02/09/2021 17:20:00
01/09/2021 12:08:00
03/09/2021 15:25:00
03/09/2021 15:25:00
03/09/2021 15:25:00
03/09/2021 15:25:00
03/09/2021 15:25:00
03/09/2021 15:25:00
03/09/2021 15:25:00
01/09/2021 18:08:00
01/09/2021 18:08:00
01/09/2021 18:08:00
01/09/2021 19:41:00
01/09/2021 19:41:00
03/09/2021 15:33:00
03/09/2021 15:33:00
03/09/2021 15:33:00
03/09/2021 15:33:00
02/09/2021 16:25:00
03/09/2021 0:13:00
03/09/2021 19:44:00
03/09/2021 19:44:00
03/09/2021 20:36:00
03/09/2021 20:36:00
03/09/2021 22:42:00
03/09/2021 22:42:00
03/09/2021 22:42:00
04/09/2021 8:12:00
04/09/2021 8:12:00
04/09/2021 11:08:00
04/09/2021 18:55:00
05/09/2021 8:02:00
05/09/2021 8:02:00
05/09/2021 9:38:00
05/09/2021 16:00:00
05/09/2021 16:00:00
05/09/2021 16:01:00
TGL.PELAYANAN BATAL NO.RM NAMA PASIEN CARA MASUK POLIKILINIK/ RUANG CARA BAYAR DOKTER (DPJP)
03/09/2021 9:25:00 False 111387 NURUL HIDAYAT RAWAT JALAN KIA & KB UMUM PERAWAT/ BIDAN
1
DOKTER/ OPERATOR/ PELAKSANA FREQ JENIS PELAYANAN BAHP TGL.PULANG
PERAWAT/ BIDAN 1 EKG 15,000 03/09/2021 9:25:00
15,000
30/08/2021 9:31:00 False 023564 SYAFRIL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:22:15 False 023675 YUDIA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:52:21 False 024311 NURAFNI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 13:34:20 False 026242 MASRIADI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 16:19:29 False 029656 IWAN KARPANMEL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 9:41:41 False 030254 FAHDI ARIZA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:00:46 False 032152 ADE CHARLES H SIMORANGKIR RAWAT JALAN MEDICAL CHECK UP
04/09/2021 16:48:49 False 042077 YUNI SYAFRIL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:04:00 False 042385 RONI CANDRA RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:57:01 False 042744 AZWANDI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:26:52 False 043171 JOHANES UJI HANDONO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:42:56 False 043174 REY SUSI PAULINA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:12:13 False 043180 YOPPY HIDAYAT RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:16:36 False 043198 BOY HARWIN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:58:03 False 043206 NIKEN MAHARANI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 16:24:47 False 043229 ZYCO RIEZA SAPUTRA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:09:48 False 043246 APRIADI YUNARTO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:15:53 False 043256 RINI OKTORA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:01:04 False 043294 HENRY WARD RAWAT JALAN MEDICAL CHECK UP
04/09/2021 9:40:56 False 043299 KURNIAWAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:28:14 False 043326 YOHANAS RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:37:55 False 043353 HAMDI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:21:03 False 043371 FITRATUL EKA PUTRA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:41:52 False 043379 SUHENDRA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:41:22 False 043380 NIKO SATRIA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:40:22 False 043384 NUR ICHSANUDIN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:46:15 False 043386 AMRIZAL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:01:40 False 043393 ANTONIUS JONPITER RAWAT JALAN MEDICAL CHECK UP
04/09/2021 16:21:44 False 043401 JUMARTONI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:41:00 False 043440 JAMOT HASINTONGAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:19:33 False 043483 MARDIKAL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:42:20 False 043488 SUKRESNO RUSHARTANTO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:18:55 False 043494 ENDANG YUNARNI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:00:06 False 043502 CANDRA ISWARI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:38:39 False 043533 ARIS MULYADI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:39:36 False 043534 PARLINGGOMAN TAMBUNAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:10:32 False 043596 AFRIZAL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 16:27:32 False 043610 NURLAILA NOVI HAMDANI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:14:22 False 046312 BAMBANG ADI KARTIKO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:34:02 False 046946 NORISMANTO RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:20:00 False 046949 JUNERI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:01:08 False 046972 ARI SETIAWAN RAWAT JALAN MEDICAL CHECK UP
03/09/2021 12:53:06 False 046984 JULIAN HADI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:59:41 False 046991 IBNU ICHSAN RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:28:28 False 046996 SAHMINAN RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:44:32 False 046997 MARIO PUTRA RAWAT JALAN MEDICAL CHECK UP
02/09/2021 9:50:09 False 047008 ERWAN RAWAT JALAN MEDICAL CHECK UP
31/08/2021 9:25:25 False 047013 RENDI FERNANDO RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:10:31 False 047017 SUDIRMAN RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:49:17 False 047020 RIKI KURNIAWAN RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:34:10 False 047021 HENDRI GUSTIAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:51:03 False 047024 FERY ALDY RAWAT JALAN MEDICAL CHECK UP
03/09/2021 9:13:19 False 047032 MARWAN RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:30:43 False 047036 BADRUSSAMSI RAWAT JALAN MEDICAL CHECK UP
01/09/2021 10:06:01 False 047065 AZIZI ANUAR RAWAT JALAN MEDICAL CHECK UP
31/08/2021 9:04:25 False 047074 TOGI MANURUNG RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:02:30 False 047083 MUHAMMAD RAJES RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:17:00 False 047091 ISRAL RAWAT JALAN MEDICAL CHECK UP
03/09/2021 12:53:28 False 047095 YOLLI MALINTON RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:09:34 False 047140 SYAFRI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:19:55 False 047146 ANGGIAT BOSMAN RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:39:00 False 047147 PERMANTO SIPAHUTAR RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:11:23 False 047151 RUSLI RAWAT JALAN MEDICAL CHECK UP

04/09/2021 11:20:23 False 047152 BUJANG TASPI RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:10:49 False 047153 TAUFIK AGUSMAL RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:14:03 False 047165 HARRY ERDIANSYAH RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:07:07 False 047166 SYAMSIAS FADLI RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:17:19 False 047170 M. ASRIL B RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:22:50 False 047171 SYAFRISUL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:12:47 False 047184 ARDI EKO PRASETYO RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:47:43 False 047185 MUSLIADI RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:34:53 False 047190 INDRA EKA PUTRA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:52:11 False 047191 NASRUL RAWAT JALAN MEDICAL CHECK UP

01/09/2021 8:17:43 False 047194 KHAIRI RAWAT JALAN MEDICAL CHECK UP
31/08/2021 9:01:28 False 047199 AFRISAL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:18:48 False 047219 HAMDI MAULANA RAWAT JALAN MEDICAL CHECK UP
31/08/2021 9:38:52 False 047227 NOVIALDI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 10:33:12 False 047237 RIZKI ANDUS RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:35:00 False 047248 ZULHAM EFENDI RAWAT JALAN MEDICAL CHECK UP
01/09/2021 10:06:28 False 047250 AHMAD YANI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:18:10 False 047258 SUHAIMI RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:15:56 False 047265 AHMAD RUSDI RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:36:23 False 047278 MUSMULYADI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:48:44 False 047285 SABRAN RAWAT JALAN MEDICAL CHECK UP
01/09/2021 10:13:26 False 047289 ADI WARMAN RAWAT JALAN MEDICAL CHECK UP
31/08/2021 10:37:43 False 047290 SAMSUL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:01:30 False 047293 BISTAMI RAWAT JALAN MEDICAL CHECK UP
01/09/2021 10:14:25 False 047298 ADRE OKTAFIANUS RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:21:07 False 047322 ADINAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:28:38 False 047325 ZIKRIANIS RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:44:59 False 047327 OLIYA ANDIKA RAWAT JALAN MEDICAL CHECK UP
02/09/2021 9:02:31 False 047336 RASIP HIDAYAT RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:07:00 False 047337 HERIYANTO RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:15:34 False 047340 ARIF WANDI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:16:52 False 047342 NURMAN ANGGORO SITEPU RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:15:00 False 047364 JONI EKA PUTRA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:06:14 False 047367 AL HAFIS RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:08:05 False 047372 MANGIHUT TUA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:13:08 False 047374 EFRIYANTO RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:43:25 False 047375 JUMISLAN RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:17:56 False 047383 SYAHBUDDIN RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:55:02 False 047397 JULIAWAN RAWAT JALAN MEDICAL CHECK UP

03/09/2021 16:06:52 False 047399 ADE AMRI RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:37:10 False 047400 MUSTAMI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:53:01 False 047433 AFRI WANDRI RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:14:39 False 047434 ADRIAN HIDAYAT RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:50:56 False 047455 NEFRIZON RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:15:32 False 047482 HENDRIK FERDIANSYAH RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:16:00 False 047501 IMAM BASUKI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:31:49 False 047520 ANTO PASARIBU RAWAT JALAN MEDICAL CHECK UP
01/09/2021 9:17:16 False 047533 MAKMUR SARAGIH RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:15:57 False 047696 ERI SAPUTRA RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:22:12 False 048204 TAWADA SITUMEANG RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:33:58 False 048597 SAMBUDIWAN RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:34:38 False 048687 PUJO SISWOYO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:50:35 False 048729 YAN ANTONO RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:25:00 False 048779 SYAMSIRMAN RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:37:43 False 048809 RONI CHANDRA RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:27:00 False 054966 LIONO SIRAIT RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:58:27 False 056457 EKA AFRIANTO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:50:09 False 056753 BAMBANG IRWANSYAH RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:12:00 False 056894 AHMAD FAUZI LUBIS RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:03:18 False 057920 A J FRENGKI TAMBUNAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:07:17 False 060694 DANIEL PRIMA RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:50:13 False 063274 HENDRI YADI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:33:33 False 063371 WAHYONO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:39:57 False 063819 MIRZA AHMAD TAUFIK RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:05:52 False 065500 KHAIRUL GUSNI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 11:11:00 False 066480 ANGGIA TRI SAPUTRA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:51:55 False 066544 IDEN GUNAWAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:15:02 False 068193 RICHO SUTRISNO RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:59:50 False 068576 EDI SYAFRIANTO RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:33:57 False 069008 PRIAN SEPTIANSYAH RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:37:42 False 069572 ANDRIZAL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:37:21 False 069574 AFMI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:06:54 False 069575 ARLIM RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:23:30 False 069580 RAMINO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:23:54 False 069585 NANDA PRATAMA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:06:20 False 069589 KELVIN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:17:39 False 069854 WANDA ADRIZAL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:09:04 False 069856 EFENDI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:17:18 False 069973 PRAMUDIA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:02:01 False 070272 MUHAMMAD ISMAIL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:05:58 False 070393 FEBRI ERIZAL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:14:20 False 070436 YASRI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:30:48 False 072893 SIHAR MARULI TUA NAPITUPULU RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:22:54 False 073149 JONI NURSAL RAWAT JALAN MEDICAL CHECK UP
03/09/2021 12:52:43 False 073150 TIMBUL PARULIAN SIPAHUTAR RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:24:13 False 073197 MAKRIFATULLAH RAWAT JALAN MEDICAL CHECK UP

04/09/2021 11:58:00 False 073198 MASRIL RAWAT JALAN MEDICAL CHECK UP
31/08/2021 9:25:57 False 073200 ALDI AGUSTIAN PRATAMA RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:25:40 False 073202 RATMO DEKI RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:10:11 False 073203 ANDRI YANTO RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:13:05 False 073205 RISKI FERNANDO RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:23:47 False 073211 MASRI ARI EFENDI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:24:43 False 073222 SUJATNO RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:12:19 False 073230 ADE SUWANDI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:02:09 False 073327 RAHMAD SYAHPUTRA RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:37:54 False 073329 ZURIANTO SYAHPUTRA RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:23:14 False 073330 MEMO RAWAT JALAN MEDICAL CHECK UP
02/09/2021 10:27:31 False 073498 SANDI AFRIANTO RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:29:51 False 073551 OKI YUSSA PUTRA RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:35:58 False 073615 RUDI SIHOMBING RAWAT JALAN MEDICAL CHECK UP
31/08/2021 9:06:54 True 073777 GIANTO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:05:22 False 074074 MIRZA GUNAWAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:50:26 False 074376 AFRIO NALDI RAWAT JALAN MEDICAL CHECK UP
01/09/2021 9:02:04 False 074635 DARMAWARDI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 10:33:00 False 075478 KARYA PUTRA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:16:13 False 076013 LISA ADRIYENI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:35:15 False 076690 SUCY KARTIKA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:06:15 False 077187 NUR RAHMAJUNI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:03:41 False 077192 SAPRIL PANJAITAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:02:04 False 077737 GUSNELDI RAIZ RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:18:51 False 078205 ARDAT PANJAITAN RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:17:31 False 079537 RENDI MARLIS RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:52:37 False 079538 MUHAMMAD FIRDAUS RAWAT JALAN MEDICAL CHECK UP
04/09/2021 9:42:04 False 079589 HENDRA EKA PURBA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:35:12 False 080147 ANDI ERIANTO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:04:49 False 080188 WAHYU AFRIANDI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:21:25 False 080190 HAMONANGAN LINGGA RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:23:00 False 080238 SYAHRIZAL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:48:12 False 080389 AMIRUDIN RAWAT JALAN MEDICAL CHECK UP

04/09/2021 13:47:38 False 080390 ROSTIANIZAR RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:01:03 False 081458 NOFRIYALDI RAWAT JALAN MEDICAL CHECK UP
03/09/2021 12:53:50 False 081576 CORY YULIA RAHMI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:06:36 False 082906 YOPIZAH APNI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 11:09:00 False 083511 RAUF SOFWANDA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:15:11 False 083613 MASRIZAL RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:01:46 False 084783 T. ILHAM ASBI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:38:21 False 085769 MUHAMMAD AMIN LUBIS RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:21:59 False 085771 HENDRA RAWAT JALAN MEDICAL CHECK UP
02/09/2021 9:12:46 False 086227 MARYADI RAWAT JALAN MEDICAL CHECK UP

03/09/2021 8:23:21 False 086530 ANGGIAT TOBING RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:09:26 False 089997 ANDRE RAHMAT RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:23:58 False 092434 PARISTON SINAGA RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:25:49 False 100845 HAMBALI RAWAT JALAN MEDICAL CHECK UP
31/08/2021 9:24:44 False 100890 RERES ALFARINO RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:08:46 False 100932 ZUHILMI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 9:28:19 False 100967 SUTIHAT RAWAT JALAN MEDICAL CHECK UP
02/09/2021 9:49:31 False 100969 HENGKI TERNANDO RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:11:00 False 103041 HOT ASI SORITUA RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:11:00 False 103041 HOT ASI SORITUA RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:36:34 False 109674 SUARDI RAWAT JALAN MEDICAL CHECK UP

02/09/2021 8:11:58 False 110119 BAKTI SIMANUNGKALIT RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:30:42 False 110933 MANGARA PARDAMEAN MUNTE RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:11:06 False 111216 FIRMAN RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:13:24 False 111217 SAFRON RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:18:27 False 111218 HENDRA KUSUMA RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:20:09 False 111219 MUHAMMAD ROZALI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:28:03 False 111220 FAIZAL RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:30:48 False 111221 RAHMAD HIDAYAT RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:32:04 False 111222 JOHAN AFRIZAL RAWAT JALAN MEDICAL CHECK UP
30/08/2021 8:34:13 False 111223 AGUS FITRI YANTO RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:01:08 False 111227 TRI HERU MARGONO RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:02:48 False 111228 MUHAMMAD TAUFIK RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:09:14 False 111229 IRWAN RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:16:00 False 111230 ABDUL BASID RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:18:00 False 111231 SUPRIADI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:19:24 False 111232 ILHAM MUDDIN RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:20:00 False 111233 MUHAMMAD SANDI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:21:15 False 111234 DEDI FITRA RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:23:00 False 111235 NASRUDIN RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:29:21 False 111236 YUHELFI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:35:25 False 111237 ARIF ROHMADI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:38:53 False 111239 ZUKRI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:40:10 False 111240 ARIFIN RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:45:00 False 111241 FERNANDO RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:46:43 False 111242 BUDI IRAWAN RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:56:17 False 111245 JEFRI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:58:13 False 111247 SEMI ORIT RAWAT JALAN MEDICAL CHECK UP
30/08/2021 9:59:22 False 111248 MOHAMMAD RISKI RAWAT JALAN MEDICAL CHECK UP
30/08/2021 10:02:15 False 111249 HERMAN RAWAT JALAN MEDICAL CHECK UP
30/08/2021 10:04:00 False 111250 LAMBOS NATENAEL SIMARMATA RAWAT JALAN MEDICAL CHECK UP
30/08/2021 10:16:30 False 111252 ILHAM W RAWAT JALAN MEDICAL CHECK UP
30/08/2021 10:18:00 False 111253 DANIEL SITOMPUL RAWAT JALAN MEDICAL CHECK UP
30/08/2021 10:49:00 False 111255 PURWANTO RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:19:52 False 111273 LADIMER SIHOMBING RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:21:37 False 111274 ANDES KHAN RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:24:00 False 111275 ISMAN RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:32:43 False 111276 EGA NANDA ANDREAS RAWAT JALAN MEDICAL CHECK UP
31/08/2021 8:34:21 False 111277 IDRUS RAWAT JALAN MEDICAL CHECK UP
31/08/2021 9:03:25 False 111280 MALFION RAWAT JALAN MEDICAL CHECK UP
31/08/2021 9:17:09 False 111281 ANDREAS RISKI WANDRI RAWAT JALAN MEDICAL CHECK UP
31/08/2021 9:29:50 False 111283 YAN PRATAMA RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:27:50 False 111302 MUHAMMAD SYUKRI EVAN RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:36:00 False 111303 RAFFI ALDERIZI RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:38:00 False 111304 RIZA PITO MANANGALA RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:40:00 False 111305 RANDY RIZMAWAN RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:41:00 False 111306 MUHAMMAD RIDO RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:44:00 False 111307 SUANTO RAWAT JALAN MEDICAL CHECK UP
01/09/2021 8:46:00 False 111308 MUHAMMAD RONI RAWAT JALAN MEDICAL CHECK UP
01/09/2021 9:08:00 False 111310 EDI SUTIYA RAWAT JALAN MEDICAL CHECK UP
01/09/2021 9:15:18 False 111311 RIO MARATUA RITONGA RAWAT JALAN MEDICAL CHECK UP
01/09/2021 10:09:48 False 111315 ARIANTO RAWAT JALAN MEDICAL CHECK UP
01/09/2021 10:12:42 False 111316 ZULFAN IRWANDA RAWAT JALAN MEDICAL CHECK UP
01/09/2021 10:48:05 False 111318 EKO DWIKI MANALU RAWAT JALAN MEDICAL CHECK UP
01/09/2021 11:31:56 False 111320 TRISMARTION R RAWAT JALAN MEDICAL CHECK UP
01/09/2021 14:36:07 False 111326 HENDRA AKMAL RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:16:11 False 111342 ANDRI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:20:47 False 111343 MASRIONO RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:22:36 False 111344 RAMLI RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:26:05 False 111345 RONI SAPUTRA RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:29:58 False 111346 DEDDY ARMAN RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:33:07 False 111348 SUPRIANTO RAWAT JALAN MEDICAL CHECK UP
02/09/2021 8:47:03 False 111350 TOLHAS SIMANJUNTAK RAWAT JALAN MEDICAL CHECK UP
02/09/2021 10:18:29 False 111359 AMARULLAH RAWAT JALAN MEDICAL CHECK UP
02/09/2021 10:49:09 False 111360 FREADE AKBAR RAWAT JALAN MEDICAL CHECK UP
02/09/2021 11:05:00 False 111361 WENDI RESMANA RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:19:41 False 111379 YAHYA GUNAWAN RAWAT JALAN MEDICAL CHECK UP
03/09/2021 8:42:05 False 111381 TEGUH SANTOSO RAWAT JALAN MEDICAL CHECK UP
03/09/2021 9:03:01 False 111383 SYAFRIZAL RAWAT JALAN MEDICAL CHECK UP
03/09/2021 9:20:24 False 111386 WEWEN ALBI MAYU RAWAT JALAN MEDICAL CHECK UP
03/09/2021 9:28:43 False 111388 BELA HERBA RAWAT JALAN MEDICAL CHECK UP
03/09/2021 9:32:53 False 111389 JAMSON SITOMPUL RAWAT JALAN MEDICAL CHECK UP
03/09/2021 9:46:47 False 111393 HENDRI RAWAT JALAN MEDICAL CHECK UP
03/09/2021 10:05:46 False 111394 RICO PANJAITAN RAWAT JALAN MEDICAL CHECK UP
03/09/2021 10:31:33 True 111394 RICO PANJAITAN RAWAT JALAN MEDICAL CHECK UP
03/09/2021 11:49:11 False 111410 ERWIN RAWAT JALAN MEDICAL CHECK UP
03/09/2021 11:49:00 False 111410 ERWIN RAWAT JALAN MEDICAL CHECK UP
03/09/2021 12:52:17 False 111412 WANDA ANTONIO RAWAT JALAN MEDICAL CHECK UP
03/09/2021 12:55:00 False 111413 ATRIA OLIVIA KEMALA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 9:43:23 False 111457 NASRUDDIN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 9:45:00 False 111458 MARTIN WASKITO MARBUN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:21:00 False 111459 ULUL AZMI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:00:41 False 111460 SYAMSUL RIZAL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:03:23 False 111461 MIDUN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:05:07 False 111462 MUHAMMAD GURUH RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:18:28 False 111463 HAIBAN FAHMI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:35:12 False 111464 SUDARTO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:37:01 False 111465 NANDO MARBUN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:38:37 False 111466 RIFANDI WAHYUDI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:53:17 False 111467 SUGENG PRATOMO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 10:59:43 False 111468 BUDI RIADI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:02:52 False 111469 BAHTIMI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:06:08 False 111470 M FAKHRUL GHANI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:10:32 False 111472 JANET ROYSTON HUTAGALUNG RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:17:14 False 111473 JUNAIDI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:19:09 False 111474 ROLIN SIBARANI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:21:31 False 111475 KARLIM SILALAHI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:22:56 False 111476 BENNI SIAGIAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:25:06 False 111477 MHD IQBAL SIDIK KEBAAR RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:27:46 False 111478 SYOFIAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:36:33 False 111479 DONI ARDI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:39:47 False 111480 RIZKI AKHBAR RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:49:52 False 111481 RILHAKMAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 11:54:56 False 111482 JALIL ISHAQ RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:02:13 False 111483 LEO PATRA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:07:58 False 111484 DANIEL EDEN NICOLAS RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:21:00 False 111485 IRSYAD IRFANSYAH DESMAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 12:23:37 False 111486 ARLIUS RAWAT JALAN MEDICAL CHECK UP

04/09/2021 13:17:34 False 111488 THESADRIA GUNAWAN S RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:19:44 False 111489 ADI LISANDI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:20:45 False 111490 JON VAIZAL RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:21:51 False 111491 INDRIA SUSANTO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:27:20 False 111492 ULIL AMRI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:28:25 False 111493 BOY SUJA PRASETYA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:37:32 False 111494 RIDWAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:47:15 False 111495 ABDUL LATIF RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:49:46 False 111496 ADE IRAWAN SAPUTRA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:54:29 False 111497 MUHAMAD TAMRIN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:55:42 False 111498 GEMPUR ARIADI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:57:09 False 111499 NASIB SIMANJUNTAK RAWAT JALAN MEDICAL CHECK UP
04/09/2021 13:58:23 False 111500 RIKI INDRA DODI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:00:16 False 111501 MULYADI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:01:23 False 111502 ALBA GUMELAR RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:03:18 False 111503 ARIEF AL ASHARI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:05:04 False 111504 RIO NURSAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:07:19 False 111505 DAVID SAPUTRA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:08:24 False 111507 ELWIS PRANATA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:09:35 False 111508 RESNU ERSHA ARYADANA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:10:27 False 111509 DESWANDI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:11:24 False 111510 RAHMAT FITRIO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:12:51 False 111511 HIDAYATULLAH RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:14:23 False 111512 ANDHIKA PUTRA TARIKAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:18:32 False 111513 ZAMARLIS RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:36:26 False 111514 MUHAMMAD ICKSAN SIREGAR RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:38:14 False 111515 SUHARYONO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:39:59 False 111517 TATANG SUANDA RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:46:41 False 111518 NIRWANDA SUKRIANTO RAWAT JALAN MEDICAL CHECK UP
04/09/2021 14:49:12 False 111519 HERU HERMAWAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 16:09:48 False 111522 RAHMADILA SARI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 16:50:27 False 111524 SELLY DWINTA PUTRI RAWAT JALAN MEDICAL CHECK UP
04/09/2021 16:51:38 False 111525 ANDI WARMAN RAWAT JALAN MEDICAL CHECK UP
04/09/2021 16:54:39 False 111526 DION PERMATA RAWAT JALAN MEDICAL CHECK UP
1,242
CARA BAYAR DOKTER (DPJP) DOKTER/ OPERATOR/ FREQ JENIS PELAYANAN BAHP
PELAKSANA
AKM PT BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 10,000
AKM PT BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 15,000
AKM PT BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
AKM PT BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
VHADANA PT DEA OKTOVIANI,DR DEA OKTOVIANI,DR 1 MCU 10,000
VHADANA PT DEA OKTOVIANI,DR HERMADIA,DR,SP.PD 1 EKG 15,000
VHADANA PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
VHADANA PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
SM .PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
SM .PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
SM .PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
VHADANA PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
VHADANA PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
VHADANA PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
SM .PT DEA OKTOVIANI,DR DEA OKTOVIANI,DR 1 MCU 10,000
SM .PT DEA OKTOVIANI,DR HERMADIA,DR,SP.PD 1 EKG 15,000
SM .PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
SM .PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
SKM.PT BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 10,000
SKM.PT BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 15,000
SKM.PT BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
SKM.PT BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
PROTON.PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
PROTON.PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 25,000
PROTON.PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
PROTON.PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 60,000
PROTON.PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 NARKOBA PAKET 5 145,000

BOHAI PT BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 10,000
BOHAI PT BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 15,000
BOHAI PT BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
BOHAI PT BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
SM .PT BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 10,000
SM .PT BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
SM .PT BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
SM .PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
SM .PT BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 15,000


VHADANA PT BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 10,000
VHADANA PT BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
VHADANA PT BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000

VHADANA PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
VHADANA PT BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 15,000



BOHAI PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
BOHAI PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
BOHAI PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000

BOHAI PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
SKM.PT DEA OKTOVIANI,DR DEA OKTOVIANI,DR 1 MCU 10,000
SKM.PT DEA OKTOVIANI,DR HERMADIA,DR,SP.PD 1 EKG 15,000
SKM.PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
SKM.PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000

RIFANSI PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
RIFANSI PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 25,000
RIFANSI PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
RIFANSI PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 60,000
RIFANSI PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 NARKOBA PAKET 5 145,000
TOP.PT BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 10,000
TOP.PT BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 15,000
TOP.PT BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
TOP.PT BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
WIFQAS PT DEA OKTOVIANI,DR DEA OKTOVIANI,DR 1 MCU 10,000
WIFQAS PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000

WIFQAS PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 50,000
TOP.PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
TOP.PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
TOP.PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
TOP.PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
TOP.PT DEA OKTOVIANI,DR DEA OKTOVIANI,DR 1 MCU 10,000
TOP.PT DEA OKTOVIANI,DR HERMADIA,DR,SP.PD 1 EKG 15,000
TOP.PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
TOP.PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
TOP.PT RAFISHA PUTRI FELLADIRA, DR ADMINISTRATOR 1 KIMIA DARAH MCU 80,000

SERTCO QUALITY RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
PT
SERTCO QUALITY RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
PT
SERTCO QUALITY RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
PT
SERTCO QUALITY RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
PT
SERTCO QUALITY BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 10,000

PT
SERTCO QUALITY BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 15,000
PT
SERTCO QUALITY BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
PT
SERTCO QUALITY BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
PT

UMUM MUHAMMAD YUSUF, DR ADMINISTRATOR 1 REGISTRASI RAWAT (10,000)

JALAN
WIFQAS PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
WIFQAS PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
WIFQAS PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
WIFQAS PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 50,000
CERIA UTAMA PT MUHAMMAD YUSUF, DR ARDI SUHENDRA 1 RAPID TEST ANTIGEN 19,000
SAFARI PUTRA MUHAMMAD YUSUF, DR ARDI SUHENDRA 1 RAPID TEST ANTIGEN 19,000
RIAU PT

WIFQAS PT BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 10,000
WIFQAS PT BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 15,000
WIFQAS PT BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
WIFQAS PT BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 50,000
PT
PT
PT
PT
PT
PT
PT
PT
SUPRACO MCU MUHAMMAD YUSUF, DR ARDI SUHENDRA 1 RAPID TEST ANTIGEN 19,000

PT
PT
PT
PT
PT
PT
PT
WIFQAS PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
WIFQAS PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
WIFQAS PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
WIFQAS PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 50,000
AWAL BROSS PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
AWAL BROSS PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
AWAL BROSS PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
WIFQAS PT BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 10,000
WIFQAS PT BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 15,000
WIFQAS PT BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
WIFQAS PT BELLA TAMARA,DR ARTIKA APRIYOLA, AMD.KEB 1 KIMIA DARAH MCU 50,000

BOHAI PT RAFISHA PUTRI FELLADIRA, DR RUSDAYANI, DR, SP. M 1 KIMIA DARAH MCU 80,000
VHADANA PT RAFISHA PUTRI FELLADIRA, DR ADMINISTRATOR 1 DARAH RUTIN MCU 50,000
BESMINDO MCU BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
BESMINDO MCU BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 50,000
UMUM RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
UMUM RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
UMUM RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
UMUM RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
UMUM DEA OKTOVIANI,DR DEA OKTOVIANI,DR 1 MCU 10,000
UMUM DEA OKTOVIANI,DR HERMADIA,DR,SP.PD 1 EKG 15,000
UMUM DEA OKTOVIANI,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
UMUM DEA OKTOVIANI,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
APS PT BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 30,000
APS PT BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 25,000
APS PT BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 60,000
APS PT BELLA TAMARA,DR ARDI SUHENDRA 1 GLUKOSA PUASA 2,000
APS PT BELLA TAMARA,DR LUSI ANGGRAINI, AMD. RAD 1 THORAX AP/PA 45,000
APS PT BELLA TAMARA,DR ARDI SUHENDRA 1 NARKOBA PAKET 6 300,000
APS PT BELLA TAMARA,DR YELVITA ROZA, DR, SP.THT-KL 1 AUDIOMETRI 25,000

UMUM BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 10,000
UMUM BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 15,000
UMUM BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
UMUM BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 50,000
EJP PT BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 15,000
EJP PT BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 50,000
EJP PT BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
EJP PT BELLA TAMARA,DR ARDI SUHENDRA 1 GLUKOSA PUASA 2,000
EJP PT BELLA TAMARA,DR LUSI ANGGRAINI, AMD. RAD 1 THORAX AP/PA 20,000

BESMINDO MCU BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 10,000
BESMINDO MCU BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
BESMINDO MCU BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 60,000
BESMINDO MCU BELLA TAMARA,DR ARDI SUHENDRA 1 NARKOBA PAKET 5 145,000

UMUM BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 25,000
UMUM BELLA TAMARA,DR ARDI SUHENDRA 1 NARKOBA PAKET 5 145,000
UMUM DEA OKTOVIANI,DR ARDI SUHENDRA 1 NARKOBA PAKET 5 145,000
BESMINDO MCU DEA OKTOVIANI,DR HERMADIA,DR,SP.PD 1 EKG 10,000
BESMINDO MCU DEA OKTOVIANI,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
BESMINDO MCU DEA OKTOVIANI,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 60,000
BESMINDO MCU DEA OKTOVIANI,DR ARDI SUHENDRA 1 NARKOBA PAKET 5 145,000
SERTCO QUALITY DEA OKTOVIANI,DR DEA OKTOVIANI,DR 1 MCU 10,000

PT
SERTCO QUALITY DEA OKTOVIANI,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
PT
SERTCO QUALITY DEA OKTOVIANI,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
PT
PT
SERTCO QUALITY DEA OKTOVIANI,DR HERMADIA,DR,SP.PD 1 EKG 15,000
PT
PT
PT
DINAMIKA PT DEA OKTOVIANI,DR DEA OKTOVIANI,DR 1 MCU 60,000
DINAMIKA PT DEA OKTOVIANI,DR HERMADIA,DR,SP.PD 1 EKG 25,000
DINAMIKA PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 60,000
DINAMIKA PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 GLUKOSA PUASA 2,000
DINAMIKA PT DEA OKTOVIANI,DR LUSI ANGGRAINI, AMD. RAD 1 THORAX AP/PA 45,000
DINAMIKA PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 NARKOBA PAKET 6 300,000
DINAMIKA PT DEA OKTOVIANI,DR ADMINISTRATOR 1 RAPID TEST ANTIGEN 29,000
BOHAI PT DEA OKTOVIANI,DR DEA OKTOVIANI,DR 1 MCU 10,000
BOHAI PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
BOHAI PT DEA OKTOVIANI,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
AKM PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
AKM PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
AKM PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
AKM PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
UMUM RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
UMUM RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
UMUM RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
UMUM RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 50,000
UMUM RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 NARKOBA PAKET 5 115,000
BESMINDO MCU RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 10,000
BESMINDO MCU RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
BESMINDO MCU RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 60,000
BESMINDO MCU RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 NARKOBA PAKET 5 145,000
APS PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
APS PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 25,000
APS PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
APS PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 60,000
APS PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 NARKOBA PAKET 5 145,000

LBD PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
LBD PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
LBD PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
LBD PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
BOHAI PT RAFISHA PUTRI FELLADIRA, DR ADMINISTRATOR 1 REGISTRASI RAWAT (10,000)

JALAN
UMUM SYARAFINA RAIHAN, DR SYARAFINA RAIHAN, DR 1 PEMERIKSAAN FISIK 47,500
MCU
UMUM SYARAFINA RAIHAN, DR RADIOGRAFER 1 THORAX AP/PA 45,000

PT
PT
PT
PT
PT
PT
PT


PT
PT
PT
PT
PT
PT
PT

PT
SERTCO QUALITY BELLA TAMARA,DR AHLI GIZI 1 EKG 15,000
PT
PT
PT
PT
PT
PT
PT
PROTON.PT BELLA TAMARA,DR BELLA TAMARA,DR 1 MCU 10,000
PROTON.PT BELLA TAMARA,DR HERMADIA,DR,SP.PD 1 EKG 25,000
PROTON.PT BELLA TAMARA,DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
PROTON.PT BELLA TAMARA,DR ARDI SUHENDRA 1 KIMIA DARAH MCU 60,000
PROTON.PT BELLA TAMARA,DR ARDI SUHENDRA 1 NARKOBA PAKET 5 145,000


PT
PT
PT
PT
SKM.PT RAFISHA PUTRI FELLADIRA, DR RAFISHA PUTRI FELLADIRA, DR 1 MCU 10,000
SKM.PT RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 15,000
SKM.PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
SKM.PT RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 80,000
PT
PT
PT
PT
PT
PT
PT

PT
PT
PT
BESMINDO MCU RAFISHA PUTRI FELLADIRA, DR HERMADIA,DR,SP.PD 1 EKG 10,000
BESMINDO MCU RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 DARAH RUTIN MCU 50,000
BESMINDO MCU RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 KIMIA DARAH MCU 60,000
BESMINDO MCU RAFISHA PUTRI FELLADIRA, DR ARDI SUHENDRA 1 NARKOBA PAKET 5 145,000
PT
PT
PT
PT
PT
PT
PT

PT
PT
PT
PT
PT
PT
PT
PT



PT
PT
PT
55,379,500
TGL.PULANG
30/08/2021 9:31:00
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30/08/2021 9:57:00
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30/08/2021 8:14:00
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04/09/2021 10:34:00
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02/09/2021 8:39:00
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03/09/2021 8:11:00
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31/08/2021 9:39:00
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01/09/2021 10:48:00
01/09/2021 12:57:00
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01/09/2021 14:36:00
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02/09/2021 8:16:00
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04/09/2021 16:10:00
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04/09/2021 16:55:00
04/09/2021 16:55:00
04/09/2021 16:55:00
04/09/2021 16:55:00
30/08/2021 8:52:00 False 020150 FITRI RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 9:22:00 False 028710 LENI MAISYAROH RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 8:03:00 False 031931 ASRI NORITA RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 8:34:00 False 036536 CAHYA MEGAWATI RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 9:36:00 False 042927 EFRIDESI RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 6:36:00 False 042952 MAWARTI S RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 8:00:00 False 043860 NURLENA RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 18:13:00 False 049402 DEWI KRISTINA RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 15:32:00 False 051173 EVALIN SARA RAWAT JALAN KEBIDANAN & KANDUNGAN
31/08/2021 15:43:00 False 052101 BERLIANA NABABAN RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 14:43:00 False 053502 LIS AFRIANI RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 14:45:00 False 058129 DEWI SUSI SARTIKA TAMBUNAN RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 8:46:00 False 058706 LISA ROTUA HUTAHAEAN RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 16:55:00 False 062025 NILA RAWAT JALAN KEBIDANAN & KANDUNGAN
04/09/2021 14:34:00 False 062149 OKTARI SASMITA RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 9:48:00 False 062927 SISCA SIMANUNGKALIT RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 9:23:00 False 063908 ROSMAWATI RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 10:28:00 False 065258 LINDAWATI RAWAT JALAN KEBIDANAN & KANDUNGAN
31/08/2021 8:20:00 False 068622 HENNY GUSLINA RAWAT JALAN KEBIDANAN & KANDUNGAN
31/08/2021 7:59:00 False 070442 LISA YULIA NINGSIH RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 10:06:00 False 072912 WINDI WULAN DARI RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 9:02:00 False 073456 HESTI MEILANY RAWAT JALAN KEBIDANAN & KANDUNGAN
04/09/2021 17:47:00 False 073761 YONA MAULIANDA RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 11:21:00 False 074268 NURHALIMAH RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 6:45:00 False 076283 ULFA RAHMI RAWAT JALAN KEBIDANAN & KANDUNGAN
04/09/2021 19:37:00 False 076656 SUSILAWATI RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 10:24:00 False 082925 YURIKO FITRIA EKA PUTRI RAWAT JALAN KEBIDANAN & KANDUNGAN
31/08/2021 7:24:00 False 084069 DIAN EVALITA RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 9:46:00 False 084922 MERRY MAHDALENA RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 8:13:12 False 086974 DEWI PURWATI RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 8:57:00 False 087226 DIANA WAHYUNI RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 9:24:00 False 088666 SUSI NAINGGOLAN RAWAT JALAN KEBIDANAN & KANDUNGAN
31/08/2021 9:23:00 False 088745 ZULFIA SISKA WATI RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 12:35:00 False 090086 LIDIANA RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 12:37:00 False 098601 BUDI YANTI RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 8:29:00 False 100143 ROSA AMELIA RAWAT JALAN KEBIDANAN & KANDUNGAN
31/08/2021 10:37:00 False 103179 GRAVIKA DIAN LESTARI RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 9:20:00 False 104099 ROSA NOVITA RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 10:21:00 False 105492 MAYA SARI RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 9:51:00 False 105727 TITIN YULINDA RAWAT JALAN KEBIDANAN & KANDUNGAN
04/09/2021 8:20:00 False 106219 DIAN OKTAVIANI SIMBOLON RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 15:40:00 False 107923 EKA YULIANI RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 8:38:00 False 108396 MIRNA FIRDA YANTI RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 15:01:00 False 108398 DIAN SANKIA DEWI RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 10:59:00 False 108408 HAZIZAH RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 14:24:00 False 108719 NINA ANWAR RAWAT JALAN KEBIDANAN & KANDUNGAN
04/09/2021 8:15:00 False 108757 ADE SURYANI PRATIWI RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 8:48:00 False 109074 DAHLIA IDUL FITRI SIAHAAN RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 9:14:00 False 109200 PUTRI UTARI RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 11:03:00 False 109205 INDRIANI RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 8:41:00 False 109238 TETTY MAYSENA BR GINTING RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 9:38:00 False 109405 FIKA LESTARI RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 9:19:00 False 109467 ELISA RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 8:47:00 False 109570 ENI MARYANA RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 8:36:00 False 110067 FAUZIAH LUBIS RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 19:33:00 False 110105 NINDY DESPITASARI RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 11:21:00 False 110171 HOT JUSNIATI RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 15:10:00 False 110249 NOVA SULISTIANI RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 11:23:00 False 110807 SOFIA RIANI RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 8:34:00 False 110936 RINI FEBRITA RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 14:18:00 False 110962 DEWI SANTI MARLINA RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 10:39:00 False 111140 HARYATI RAWAT JALAN KEBIDANAN & KANDUNGAN
04/09/2021 11:10:00 False 111140 HARYATI RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 7:49:00 False 111154 SUSANTI RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 9:37:00 False 111159 RATNA SARI RAWAT JALAN KEBIDANAN & KANDUNGAN
04/09/2021 8:48:00 False 111189 VICTORIA ADELINA PANJAITAN RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 8:39:00 False 111224 SHOLEHATUN RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 9:55:00 False 111243 TIURMA MANIK RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 9:56:00 False 111244 SRI RAHAYU GINTING RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 11:49:00 False 111258 SITI AGUSTINA RAWAT JALAN KEBIDANAN & KANDUNGAN
30/08/2021 13:38:00 False 111261 NURHASANAH RAWAT JALAN KEBIDANAN & KANDUNGAN
04/09/2021 8:38:00 False 111262 YULIA SAFITRI RAWAT JALAN KEBIDANAN & KANDUNGAN
31/08/2021 10:13:00 False 111285 SRI WINARNI RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 7:47:00 False 111300 REBECCA KUSUMA ASTARI RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 8:46:00 False 111309 PUTRI WULANDARI RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 9:17:00 False 111312 SARAH KHAIRANI RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 9:47:00 False 111314 MELDA BR SIHALOHO RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 10:20:00 False 111317 ELVA ROSANTI TANJUNG RAWAT JALAN KEBIDANAN & KANDUNGAN
01/09/2021 17:39:00 False 111330 INTAN AFRILIA RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 8:32:00 False 111347 MESRA NATALIA RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 8:36:00 False 111349 DEWI SAFITRI SIMANJUNTAK RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 14:34:00 False 111366 CINDY ADELA RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 9:30:00 False 111367 DILLA ALFIENI RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 17:28:00 False 111369 SRI RAHMAWATI RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 18:48:00 False 111370 ARNITA BR SIREGAR RAWAT JALAN KEBIDANAN & KANDUNGAN
02/09/2021 19:33:00 False 111371 LENI MARLINA RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 11:49:00 False 111411 NANDA HAI RANI RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 15:42:00 False 111417 ERLIANITA RAWAT JALAN KEBIDANAN & KANDUNGAN
03/09/2021 18:05:00 False 111423 SHYENNI RAWAT JALAN KEBIDANAN & KANDUNGAN
04/09/2021 8:28:00 False 111452 WAHYUNI NANDA FRIDANI RAWAT JALAN KEBIDANAN & KANDUNGAN
SIAGIAN
04/09/2021 19:54:00 False 111536 NOFI EFRIANI RAWAT JALAN KEBIDANAN & KANDUNGAN
91
CARA BAYAR DOKTER (DPJP) DOKTER/ OPERATOR/ PELAKSANA FREQ
UMUM DARWIN N.A ,DR, SPOG DARWIN N.A ,DR, SPOG 1
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG MADUMA OCTHA MARINI S, DR.SPOG 1
BPJS NON-PBI DARWIN N.A ,DR, SPOG DARWIN N.A ,DR, SPOG 1
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG H.R.ROSENO SARJANTO,DR, SPOG 1
UMUM H.R.ROSENO SARJANTO,DR, SPOG H.R.ROSENO SARJANTO,DR, SPOG 1
BPJS NON-PBI ROMAITO NASUTION, DR, SP.P MADUMA OCTHA MARINI S, DR.SPOG 1
UMUM MADUMA OCTHA MARINI S, DR.SPOG MADUMA OCTHA MARINI S, DR.SPOG 1
BPJS NON-PBI AIDI NASRUL, DR, SP.PD MADUMA OCTHA MARINI S, DR.SPOG 1
SINARMAS CARD MADUMA OCTHA MARINI S, DR.SPOG MADUMA OCTHA MARINI S, DR.SPOG 1
ADMEDIKA H.R.ROSENO SARJANTO,DR, SPOG H.R.ROSENO SARJANTO,DR, SPOG 1
PACIFIC CROSS MADUMA OCTHA MARINI S, DR.SPOG MADUMA OCTHA MARINI S, DR.SPOG 1
BNI LIFE MADUMA OCTHA MARINI S, DR.SPOG MADUMA OCTHA MARINI S, DR.SPOG 1
ASURANSI
ADMEDIKA H.R.ROSENO SARJANTO,DR, SPOG H.R.ROSENO SARJANTO,DR, SPOG 1
UMUM MADUMA OCTHA MARINI S, DR.SPOG MADUMA OCTHA MARINI S, DR.SPOG 1

JENIS PELAYANAN BAHP TGL.PULANG
USG BIASA 10,000 30/08/2021 8:52:00
USG BIASA 10,000 02/09/2021 8:34:00
USG BIASA 10,000 01/09/2021 9:36:00
USG BIASA 10,000 03/09/2021 8:00:00
USG BIASA 10,000 01/09/2021 18:13:00
USG BIASA 10,000 03/09/2021 15:32:00
USG BIASA 10,000 31/08/2021 15:43:00
USG BIASA 10,000 30/08/2021 14:43:00
USG BIASA 10,000 01/09/2021 14:45:00
USG BIASA 10,000 30/08/2021 8:46:00
USG BIASA 10,000 01/09/2021 16:55:00
USG BIASA 10,000 04/09/2021 14:34:00
USG BIASA 10,000 02/09/2021 9:23:00
USG BIASA 10,000 30/08/2021 10:28:00
USG BIASA 10,000 31/08/2021 8:20:00
USG BIASA 10,000 31/08/2021 7:59:00
USG BIASA 10,000 03/09/2021 10:06:00
USG BIASA 10,000 04/09/2021 17:47:00
INSPECULO 15,000 30/08/2021 11:21:00
USG BIASA 10,000 04/09/2021 19:37:00
USG BIASA 10,000 05/09/2021 17:03:00
USG BIASA 10,000 31/08/2021 7:24:00
USG BIASA 10,000 01/09/2021 9:46:00
USG BIASA 10,000 02/09/2021 8:13:00
USG BIASA 10,000 02/09/2021 9:24:00
USG BIASA 10,000 31/08/2021 9:23:00
USG BIASA 10,000 03/09/2021 12:35:00
USG BIASA 10,000 30/08/2021 8:29:00
USG BIASA 10,000 31/08/2021 10:37:00
USG BIASA 10,000 01/09/2021 9:20:00

USG BIASA 10,000 05/09/2021 16:23:00
USG BIASA 10,000 02/09/2021 9:51:00
USG BIASA 10,000 04/09/2021 8:20:00
USG BIASA 10,000 04/09/2021 17:42:00
USG BIASA 10,000 30/08/2021 15:01:00
USG BIASA 10,000 01/09/2021 10:59:00
USG BIASA 10,000 30/08/2021 14:24:00
USG BIASA 10,000 04/09/2021 8:15:00
INSPECULO 15,000 30/08/2021 8:48:00
USG BIASA 10,000 30/08/2021 9:14:00
USG BIASA 10,000 03/09/2021 11:03:00
USG BIASA 10,000 30/08/2021 8:41:00
USG BIASA 10,000 02/09/2021 9:19:00
USG BIASA 10,000 30/08/2021 8:36:00
USG BIASA 10,000 03/09/2021 19:33:00
USG BIASA 10,000 02/09/2021 11:21:00
USG BIASA 10,000 01/09/2021 15:10:00
USG BIASA 10,000 30/08/2021 8:34:00
USG BIASA 10,000 30/08/2021 8:39:00
USG BIASA 10,000 30/08/2021 9:55:00
USG BIASA 10,000 30/08/2021 9:56:00
USG BIASA 10,000 30/08/2021 11:49:00
USG BIASA 10,000 30/08/2021 13:38:00
USG BIASA 10,000 31/08/2021 10:13:00
USG BIASA 10,000 01/09/2021 7:47:00
USG BIASA 10,000 01/09/2021 8:46:00
USG BIASA 10,000 01/09/2021 9:17:00
USG BIASA 10,000 01/09/2021 9:47:00

USG BIASA 10,000 01/09/2021 10:20:00
USG BIASA 10,000 01/09/2021 17:39:00
USG BIASA 10,000 02/09/2021 8:32:00
USG BIASA 10,000 02/09/2021 8:36:00
USG BIASA 10,000 02/09/2021 14:34:00
USG BIASA 10,000 03/09/2021 9:30:00
USG BIASA 10,000 02/09/2021 17:28:00
USG BIASA 10,000 02/09/2021 18:48:00
USG BIASA 10,000 02/09/2021 19:33:00
USG BIASA 10,000 03/09/2021 11:49:00
USG BIASA 10,000 03/09/2021 15:42:00
USG BIASA 10,000 03/09/2021 18:05:00
USG BIASA 10,000 04/09/2021 8:28:00
USG BIASA 10,000 04/09/2021 19:54:00
1,300,000
TGL.PELAYANAN BATAL NO.RM NAMA PASIEN CARA MASUK POLIKILINIK/ RUANG CARA BAYAR
03/09/2021 14:48:13 False 028136 EVIMON RAWAT JALAN PARU BPJS NON-PBI
31/08/2021 15:39:58 False 058397 NUR HARIANTI RAWAT JALAN PARU BPJS NON-PBI
31/08/2021 15:16:08 False 068788 RINDU INSANI RAWAT JALAN PARU BPJS NON-PBI
03/09/2021 14:47:54 False 110817 ISMERI RAWAT JALAN PARU BPJS NON-PBI
30/08/2021 21:33:58 False 111259 ROSINTA RAWAT JALAN PARU BPJS NON-PBI
30/08/2021 21:33:58 False 111259 ROSINTA RAWAT JALAN PARU BPJS NON-PBI
03/09/2021 14:47:32 False 111397 REMIANNA RAWAT JALAN PARU UMUM
7
DOKTER (DPJP) DOKTER/ OPERATOR/ PELAKSANA FREQ JENIS PELAYANAN BAHP TGL.PULANG
ROMAITO NASUTION, DR, SP.P MUHAMMAD YUSUF, DR 1 THORAX AP/PA 45,000 03/09/2021 10:18:00
ROMAITO NASUTION, DR, SP.P MUHAMMAD YUSUF, DR 1 LUMBO SACRAL 110,000 30/08/2021 12:12:00
380,000
02/09/2021 18:04:06 False 049918 SUGINEM RAWAT JALAN PENYAKIT DALAM BPJS NON-PBI
02/09/2021 8:28:24 False 057692 MIDA SINAGA RAWAT JALAN PENYAKIT DALAM BPJS NON-PBI
03/09/2021 18:15:50 False 066024 NOVIA VERA RAWAT JALAN PENYAKIT DALAM BPJS NON-PBI
02/09/2021 19:35:51 False 066112 BERTA SIREGAR RAWAT JALAN PENYAKIT DALAM BPJS NON-PBI
02/09/2021 19:28:52 False 075911 MISNI RAWAT JALAN PENYAKIT DALAM UMUM
03/09/2021 7:55:00 False 108251 ILYAS MD RAWAT JALAN PENYAKIT DALAM BPJS NON-PBI
31/08/2021 8:48:00 False 111003 YETRIANIS RAWAT JALAN PENYAKIT DALAM BPJS NON-PBI
03/09/2021 17:50:27 False 111390 ROYMUN RAWAT JALAN PENYAKIT DALAM UMUM
8
DOKTER (DPJP) DOKTER/ OPERATOR/ FREQ JENIS PELAYANAN BAHP TGL.PULANG
PELAKSANA
AIDI NASRUL, DR, SP.PD MUHAMMAD YUSUF, DR 1 THORAX AP/PA 45,000 02/09/2021 9:34:00
AIDI NASRUL, DR, SP.PD AIDI NASRUL, DR, SP.PD 1 INJEKSI 2,000 03/09/2021 7:55:00
AIDI NASRUL, DR, SP.PD RADIOGRAFER 1 LUMBO SACRAL 110,000 31/08/2021 8:48:00
AIDI NASRUL, DR, SP.PD RADIOGRAFER 1 THORAX AP/PA 45,000 03/09/2021 9:35:00
382,000
TGL.PELAYANAN BATAL NO.RM NAMA PASIEN CARA MASUK POLIKILINIK/ RUANG CARA BAYAR DOKTER (DPJP)
30/08/2021 10:59:08 False 111256 MISNO RAWAT JALAN RADIOLOGI UMUM RADIOGRAFER
1
DOKTER/ OPERATOR/ PELAKSANA FREQ JENIS PELAYANAN BAHP TGL.PULANG
RADIOGRAFER 1 THORAX AP/PA 45,000 30/08/2021 10:59:00
45,000
TGL.PELAYANAN BATAL NO.RM NAMA PASIEN CARA MASUK POLIKILINIK/ CARA BAYAR
RUANG
31/08/2021 10:51:00 False 022196 DARWATI RAWAT JALAN SYARAF BPJS NON-PBI
30/08/2021 7:56:00 False 058125 ROSMETY RAWAT JALAN SYARAF BPJS NON-PBI
31/08/2021 8:14:00 False 079185 DIMITRI IVANOVIC RAWAT JALAN SYARAF BPJS NON-PBI
02/09/2021 7:31:00 False 079800 ARLIS RAWAT JALAN SYARAF BPJS NON-PBI
02/09/2021 8:04:00 False 101883 RUMLIANA SINAGA RAWAT JALAN SYARAF BPJS NON-PBI
30/08/2021 8:04:00 False 104505 TIARMA MARIA RAWAT JALAN SYARAF BPJS NON-PBI
30/08/2021 8:04:00 False 104505 TIARMA MARIA RAWAT JALAN SYARAF BPJS NON-PBI
02/09/2021 8:35:00 False 108591 JAMALUDDIN RAWAT JALAN SYARAF BPJS NON-PBI
288
FANEL PUTRA, DR.SP.N FANEL PUTRA, DR.SP.N 1 INJEKSI KHUSUS 75,000 31/08/2021 10:51:00
FANEL PUTRA, DR.SP.N RADIOGRAFER 1 LUMBO SACRAL 110,000 30/08/2021 7:56:00
FANEL PUTRA, DR.SP.N RADIOGRAFER 1 THORAX AP/PA 45,000 31/08/2021 16:26:00
FANEL PUTRA, DR.SP.N RADIOGRAFER 1 PEDIS AP + LATERAL 92,000 30/08/2021 8:04:00
FANEL PUTRA, DR.SP.N RADIOGRAFER 1 PEDIS AP + LATERAL 92,000 30/08/2021 8:04:00
639,000
30/08/2021 8:47:00 False 110524 DHEA AMORA RIAMA SIREGAR RAWAT JALAN THT BPJS NON-PBI
1
YELVITA ROZA, DR, SP.THT-KL YELVITA ROZA, DR, SP.THT-KL 1 EKSTRASI 11,000 30/08/2021 8:47:00
11,000
30/08/2021 14:11:00 False 054644 SITI RAWAT JALAN UMUM UMUM
121
BELLA TAMARA,DR MUHAMMAD YUSUF, DR 1 THORAX AP/PA 45,000 30/08/2021 14:11:00
45,000
30/08/2021 14:01:04 False 024942 MASTIUR LIANA RAWAT DARURAT RAWAT DARURAT KANDUNGAN
31/08/2021 11:16:21 False 046550 RANI PUSPITA RAWAT DARURAT RAWAT DARURAT KANDUNGAN
01/09/2021 10:44:43 False 058706 LISA ROTUA HUTAHAEAN RAWAT DARURAT RAWAT DARURAT KANDUNGAN
04/09/2021 22:56:29 False 105792 SOFIANTI RAWAT DARURAT RAWAT DARURAT KANDUNGAN
04/09/2021 23:06:00 False 105792 SOFIANTI RAWAT DARURAT RAWAT DARURAT KANDUNGAN
02/09/2021 9:02:56 False 107979 HALIMAH RAHMAYNI RAWAT DARURAT RAWAT DARURAT KANDUNGAN
02/09/2021 20:31:00 False 110520 SUMARNI RAWAT DARURAT RAWAT DARURAT KANDUNGAN
01/09/2021 16:53:38 False 110803 MANJA ELFRIDA PANJAITAN RAWAT DARURAT RAWAT DARURAT KANDUNGAN
31/08/2021 7:56:00 False 110930 YUSNIMAR RAWAT DARURAT RAWAT DARURAT KANDUNGAN
30/08/2021 18:15:00 False 111262 YULIA SAFITRI RAWAT DARURAT RAWAT DARURAT KANDUNGAN
31/08/2021 8:18:14 False 111269 SAGINA SAMOSIR RAWAT DARURAT RAWAT DARURAT KANDUNGAN
03/09/2021 4:22:00 False 111376 HELLENA ALFITRIS RAWAT DARURAT RAWAT DARURAT KANDUNGAN
04/09/2021 1:33:00 False 111446 SHELY RAMADHANI RAWAT DARURAT RAWAT DARURAT KANDUNGAN
04/09/2021 1:33:00 False 111446 SHELY RAMADHANI RAWAT DARURAT RAWAT DARURAT KANDUNGAN
38
CARA BAYAR DOKTER (DPJP) DOKTER/ OPERATOR/ PELAKSANA FREQ JENIS PELAYANAN BAHP
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG DINA MARYANA, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG DINA MARYANA, AMD. KEB 1 FEBREDING 10,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG DINA MARYANA, AMD. KEB 1 PASANG CATETER 38,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG YULIANI, S.TR.KEB 1 INJEKSI 2,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG WELVA MERI, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG WELVA MERI, AMD. KEB 1 PASANG CATETER 38,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG WELVA MERI, AMD. KEB 1 FEBREDING 10,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG RICA ROSALIN, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG RICA ROSALIN, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG RICA ROSALIN, AMD. KEB 1 PASANG CATETER 38,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG RICA ROSALIN, AMD. KEB 1 FEBREDING 10,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG FITRI ECI, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG FITRI ECI, AMD. KEB 2 INJEKSI 4,000
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG LIDIA FITRIA, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG RICA ROSALIN, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG MADUMA OCTHA MARINI S, 1 PARTUS PATOLOGIS 145,000
DR.SPOG
BPJS NON-PBI DARWIN N.A ,DR, SPOG PERAWAT/ BIDAN 1 PASANG INFUS 10,000
BPJS NON-PBI DARWIN N.A ,DR, SPOG PERAWAT/ BIDAN 1 PASANG CATETER 38,000
BPJS NON-PBI DARWIN N.A ,DR, SPOG PERAWAT/ BIDAN 1 FEBREDING 10,000
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG WELVA MERI, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG WELVA MERI, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG WELVA MERI, AMD. KEB 1 FEBREDING 10,000
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG WELVA MERI, AMD. KEB 1 PASANG CATETER 38,000
BPJS NON-PBI DARWIN N.A ,DR, SPOG WELVA MERI, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI DARWIN N.A ,DR, SPOG WELVA MERI, AMD. KEB 1 PASANG CATETER 38,000
BPJS NON-PBI DARWIN N.A ,DR, SPOG WELVA MERI, AMD. KEB 1 FEBREDING 10,000
UMUM H.R.ROSENO SARJANTO,DR, SPOG PERAWAT/ BIDAN 1 PASANG INFUS 10,000
UMUM H.R.ROSENO SARJANTO,DR, SPOG PERAWAT/ BIDAN 1 PASANG CATETER 38,000

UMUM H.R.ROSENO SARJANTO,DR, SPOG PERAWAT/ BIDAN 1 FEBREDING 10,000
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG WELVA MERI, AMD. KEB 1 PASANG INFUS 10,000
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG WELVA MERI, AMD. KEB 1 FEBREDING 10,000
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG WELVA MERI, AMD. KEB 1 PASANG CATETER 38,000
BPJS NON-PBI MADUMA OCTHA MARINI S, DR.SPOG WELVA MERI, AMD. KEB 1 INJEKSI 2,000
BPJS NON-PBI DARWIN N.A ,DR, SPOG PERAWAT/ BIDAN 1 PASANG INFUS 10,000
BPJS NON-PBI DARWIN N.A ,DR, SPOG PERAWAT/ BIDAN 1 PASANG CATETER 38,000
BPJS NON-PBI DARWIN N.A ,DR, SPOG PERAWAT/ BIDAN 1 FEBREDING 10,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG PERAWAT/ BIDAN 1 PASANG INFUS 10,000
BPJS NON-PBI H.R.ROSENO SARJANTO,DR, SPOG PERAWAT/ BIDAN 1 PASANG CATETER 38,000
749,000
TGL.PULANG
01/09/2021 16:36:00
01/09/2021 16:36:00
01/09/2021 16:36:00
01/09/2021 16:36:00
02/09/2021 19:44:00
02/09/2021 19:44:00
02/09/2021 19:44:00
03/09/2021 15:02:00
03/09/2021 15:02:00
03/09/2021 15:02:00
03/09/2021 15:02:00
05/09/2021 17:07:00
05/09/2021 17:07:00
03/09/2021 12:44:00
03/09/2021 12:44:00
03/09/2021 12:44:00
05/09/2021 16:18:00
05/09/2021 16:18:00
05/09/2021 16:18:00
04/09/2021 9:49:00
04/09/2021 9:49:00
04/09/2021 9:49:00
04/09/2021 9:49:00
02/09/2021 16:17:00
02/09/2021 16:17:00
02/09/2021 16:17:00
01/09/2021 15:33:00
01/09/2021 15:33:00
01/09/2021 15:33:00
03/09/2021 12:09:00
03/09/2021 12:09:00
03/09/2021 12:09:00
03/09/2021 12:09:00
05/09/2021 16:16:00
05/09/2021 16:16:00
05/09/2021 16:16:00
05/09/2021 11:25:00
05/09/2021 11:25:00

BHP Rajal 30-05

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BHP Rajal 30-05

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TGL.PELAYANAN BATAL NO.

RM NAMA PASIEN CARA MASUK POLIKILINIK/ RUANG

30/08/2021 10:53:00 False 040334 HAWATI RAWAT JALAN BEDAH

02/09/2021 16:42:00 False 055635 BASA IRANI RAWAT JALAN BEDAH

01/09/2021 8:09:00 False 055658 ADI APRIAN RAWAT JALAN BEDAH

02/09/2021 10:17:00 False 066524 ANDI SUCIPTO RAWAT JALAN BEDAH

31/08/2021 7:52:00 False 076103 jamarali panggabean RAWAT JALAN BEDAH

02/09/2021 8:53:00 False 079826 RISNAWATI RAWAT JALAN BEDAH

04/09/2021 7:29:00 False 088509 MUJIONO RAWAT JALAN BEDAH

31/08/2021 16:19:00 False 098254 SUTRISNO RAWAT JALAN BEDAH

02/09/2021 16:28:00 False 108694 MURNI BR SIJABAT RAWAT JALAN BEDAH

02/09/2021 9:11:00 False 109793 MARTINI PANJAITAN RAWAT JALAN BEDAH

01/09/2021 8:41:00 False 110205 ELVIDIANTO RAWAT JALAN BEDAH

04/09/2021 13:48:00 False 110412 ANTONIUS HALAWA RAWAT JALAN BEDAH

02/09/2021 8:27:00 False 110511 MARYATI RAWAT JALAN BEDAH

30/08/2021 16:41:00 False 110539 SANDIA LESTARI RAWAT JALAN BEDAH

30/08/2021 7:50:00 False 110678 DODI ARIANTO RAWAT JALAN BEDAH

02/09/2021 10:19:00 False 110696 SYAMSUAR RAWAT JALAN BEDAH

02/09/2021 10:19:00 False 110696 SYAMSUAR RAWAT JALAN BEDAH

01/09/2021 10:13:00 False 110818 ENDRI EFFENDI RAWAT JALAN BEDAH

30/08/2021 8:17:00 False 110994 NARA DEA RAWAT JALAN BEDAH

30/08/2021 8:17:00 False 110994 NARA DEA RAWAT JALAN BEDAH

04/09/2021 11:53:00 False 111065 RINI SAHARANI RAWAT JALAN BEDAH

BPJS NON-PBI RURI GUSANDI, DR, SPB ELAYANI, AMD. KEP 1

BPJS NON-PBI RURI GUSANDI, DR, SPB RADIOGRAFER 1

UMUM RURI GUSANDI, DR, SPB RURI GUSANDI, DR, SPB 1

UMUM RURI GUSANDI, DR, SPB RURI GUSANDI, DR, SPB 1

PASANG INFUS 10,000 03/09/2021 15:56:00

EKG 15,000 03/09/2021 15:56:00

GANTI VERBAN SEDANG 30,000 30/08/2021 10:53:00

GANTI VERBAN SEDANG 30,000 02/09/2021 16:42:00

GANTI VERBAN SEDANG (6-20 PCS KASSA) 30,000 01/09/2021 8:09:00

USG KELUAR 360,000 02/09/2021 10:17:00

GANTI VERBAN SEDANG (6-20 PCS KASSA) 30,000 31/08/2021 7:52:00

GANTI VERBAN SEDANG (6-20 PCS KASSA) 30,000 31/08/2021 10:24:00

AFF HEACTING 16,000 31/08/2021 10:24:00

GANTI VERBAN SEDANG 30,000 02/09/2021 8:53:00

GANTI VERBAN SEDANG (6-20 PCS KASSA) 60,000 04/09/2021 9:00:00

GANTI VERBAN SEDANG (6-20 PCS KASSA) 60,000 04/09/2021 7:29:00

GANTI VERBAN SEDANG (6-20 PCS KASSA) 30,000 31/08/2021 16:19:00

GANTI VERBAN SEDANG 30,000 02/09/2021 16:28:00

GANTI VERBAN SEDANG 30,000 02/09/2021 9:11:00

GANTI VERBAN SEDANG (6-20 PCS KASSA) 30,000 01/09/2021 8:41:00

GANTI VERBAN SEDANG (6-20 PCS KASSA) 60,000 04/09/2021 13:48:00

GANTI VERBAN SEDANG 30,000 02/09/2021 8:27:00

GANTI VERBAN SEDANG 30,000 30/08/2021 16:41:00

GANTI VERBAN SEDANG 30,000 30/08/2021 7:50:00

GANTI VERBAN SEDANG 30,000 02/09/2021 10:19:00

KONTROL ULANG AFF JAHITAN/JAHITAN 5,000 02/09/2021 10:19:00

GANTI VERBAN SEDANG 30,000 01/09/2021 10:51:00

GANTI VERBAN BESAR 35,000 01/09/2021 10:13:00

AFF HEACTING 32,000 04/09/2021 8:29:00

GANTI VERBAN SEDANG (6-20 PCS KASSA) 60,000 04/09/2021 8:29:00

GANTI VERBAN SEDANG (6-20 PCS KASSA) 30,000 30/08/2021 8:53:00

GANTI VERBAN SEDANG 30,000 03/09/2021 8:12:00

AFF HEACTING 16,000 03/09/2021 8:12:00

GANTI VERBAN SEDANG 30,000 30/08/2021 8:17:00

AFF HEACTING 16,000 30/08/2021 8:17:00

GANTI VERBAN KECIL (1-5 PCS KASSA) 20,000 31/08/2021 14:25:00

AFF HEACTING 16,000 31/08/2021 14:25:00

GANTI VERBAN SEDANG (6-20 PCS KASSA) 60,000 04/09/2021 11:53:00

GANTI VERBAN SEDANG 30,000 30/08/2021 16:49:00

AFF HEACTING 16,000 30/08/2021 16:49:00